Rice County Hospital and the community of Lyons, Kansas, have plenty to offer when it comes to attracting doctors.

Five years ago, the hospital underwent a $10.5 million remodel that turned the '50s-era building into a bright, up-to-date facility. Its two birthing suites are modern and roomy and welcome about 90 babies a year into the world. It has a new CAT scanner and stroke diagnosis equipment that video-links patients to Denver neurologists. Its busy rehab facility offers physical and occupational therapy close to home, and a large hospice room provides a peaceful retreat for patient and family. Community support and an endowed foundation have helped make all those things possible.

Lyons, home to about 3,500 residents and the county seat, is about 30 minutes from three larger cities - Great Bend, McPherson, and Hutchinson. Wichita is about 90 minutes away, and about 10 miles south is Sterling, home to Sterling College and about 2,300 people.

A town with everything ... almost

Lyons and its people have made commitments to the future. Voters approved spending $13.5 million to expand and improve schools, and the community built a new pool and water park several years ago. It's a good community to raise a family, a place "where if your kid's out messing around they're going to call you, and you don't have to worry," said Roger Tobias, M.D., who has practiced there since 1982.

On a regular basis, specialists in cardiology, rheumatology, podiatry, and urology visit the hospital's clinic to see the patients of Tobias and three other doctors in Sterling. A general surgeon comes twice weekly, and the hospital's ER sees about 200 patients a month. A block away, the hospital-owned Lyons Medical Center has more than a dozen patient rooms and was built to house up to six doctors.

The problem is, only one doctor, Tobias, practices at that large office, and at 63 he's not taking new patients. Without a nurse practitioner and a physician's assistant, the office and the nearby ER couldn't operate. Doctors from Sterling help staff the ER, see patients, and deliver babies at the hospital, but Tobias is the only doctor close at hand.

"He will be very difficult to replace," said Carol Frisbie, a longtime patient. "He's taken great care of us. It's the feeling of the old country doctor. He would make a house call if you needed. He's a pillar of the community."

Recruiting has been challenging

It's not for a lack of trying that Tobias is practicing solo. Tobias, hospital CEO George Stover, and others have been recruiting for several years. Despite having what they believe is a first-class facility and a good community, they keep coming in second with recruits.

It's a problem that hits home for Tobias in several ways. He's a native of Lyons who studied at KU School of Medicine-Wichita, did a surgical residency in Wichita, and served as an Air Force flight surgeon before deciding family practice was more to his liking. He chose to practice and raise a family - he and wife, Debbie, have two sons and a daughter - in his hometown. He plans to retire in a little over two years.

"This is his community, his town, and he wants to make sure that the people of Lyons are taken care of," Stover said.

An ironic prediction

And then there's the fact that, in 1991, Tobias was an author of a provocative report by the Kansas Academy of Family Physicians, "Where Have the Doctors Gone? When Will They Return? A Report on the Shortage of Family Physicians in Kansas." The report was intended to light a fire, and did, recommending that the KU School of Medicine turn out more primary care doctors, and pay residents in rural areas more, among other recommendations. It spurred changes - many of them good, Tobias said - but the shortage of rural family doctors remains.

"The irony of it gets to me a bit," Tobias said, now that he finds a doctor shortage in his own office.

"We have so much to offer, a fine building, equipment, colleagues. It does become frustrating to be second," Stover said. "We get those recruits who come in and go, 'Wow, what a great place.'"

But then they hear that they've come in second, that a doctor wants to live closer - or farther - from family. In April, the hospital paid to take part in an electronic recruiting event for primary care doctors. Fewer doctors "attended" than had signed up, and they spent three hours at a computer waiting for one to enter their "booth." None did - "we were skunked," Tobias said.

Having had their hopes raised, patients ask when the new doc is coming and he can tell them only that they're doing all they can. Tobias praises the community for being understanding, and hospital management for finding fill-ins that allow him to vacation or see his kids.

Heart for rural medicine starts in medical school

Tobias believes, as he long has, that medical students should experience rural practice firsthand. The Wichita campus incorporates a rural rotation requirement in its curriculum for just that purpose.

"You can't make people like small-town life if they haven't been exposed to it," Tobias says. "You've got to get them down on the farm early, to show them they could have a career and a life there."

Small-town practice has both responsibilities - being a "pillar" is one - and benefits. The doctor cares for the people, and they care right back.

"One of the most meaningful things in my life was when I had to have surgery, and I was blown away by the number of well wishes and get-well cards I got," Tobias said. "There are so many times as a doctor that you do what is expected and you think it goes unnoticed - it was amazing."

"It's being able to take care of the patients you see in church and the community," Stover said. "You get to help develop and shape the community you live in. There's a lot of young doctors for whom that's appealing."

So they'll keep recruiting. And hope to find a doctor, or two, who can see all that Lyons has to offer.